VEGAN NUTRITION FOR WOMEN

Karina:  You're listening to the No-Bullshit Vegan podcast, episode 40. Dr. Pamela Fergusson joins me today to discuss all things vegan nutrition for women. Now, you don't need to be female to benefit from this episode regardless of your own gender,  I'm willing to bet you have female-identified people in your life, whether they're daughters you're raising, an older mum you're helping, a wife, friends you care about, et cetera. We're going to delve into many different nutrition topics, including protein, iron, calcium and nutrition at different stages of life.

Hey, welcome to the show. I'm Karina, your no BS, vegan fitness and nutrition coach. I want to thank everyone who has submitted a star rating and review on iTunes lately. I really appreciate it. Here's a recent review from Dr. Chana Palmer-Davis. She says, Karina does an excellent job of guiding her guests towards sharing their wisdom in a way that is enlightening and actionable. As a scientist. I particularly appreciate the fact that she doesn't hesitate to challenge her guests on positions that are not well supported by scientific evidence. The podcast lives up to its name. Thank you so much Chana. That is awesome. I really appreciate you taking the time to do a review for me and we are actually planning on having Chana on our show later this year, so stay tuned. Anyway, if you haven't done so already, leaving a star rating and a review is the most important thing you can do right now to support the show, so head over to Nobullshitvegan.com/itunes and don't forget that I've got a ton of free resources for you at Karinainkster.com including a 350 item vegan grocery list, a 10 day how to go vegan online course and an ebook all about calories, macros, and fueling your fitness on a plant-based diet all for free at Karinainkster.com

 

Now I'm honored to introduce our kick-ass guest for today, Dr. Pamela Fergusson. She's a vegan registered dietician with a PhD in nutrition. She lives in Nelson, BC where she runs an online nutrition counseling practice. Pamela has run half marathons, a marathon and a few ultra marathons. She and her husband Dave are raising their four kids on a plant-based diet. She's worked all over the world in the field of nutrition -throughout Africa, in Southeast Asia, the UK and in the U S and Canada. Pamela's favorite vegan meal is vegan pizza from Libretto in Toronto. We're going to be talking about vegan nutrition for women throughout all stages of life, including pregnancy and menopause, and we're going to be focusing in on a few key nutrients- protein, iron and calcium. Let's get to it. Dr. Pamela Fergusson, thanks so much for joining me on the show today.

Dr. Pamela: Thank you. It's wonderful to be here.

Karina: I'm very excited. We have a really cool topic to discuss which we have not really addressed in-depth on the show yet. So I'm excited for that. But I want to start with what I ask all my guests about just to kind of get a little background and get to know you a little better, which is your vegan story. So I am interested in how and when you decided to go vegan in the first place.

Dr. Pamela: Sure. I became vegetarian first in university and I read Diet for a Small Planet and I was really concerned about the environmental impact of my diet and also very concerned about how we're going to feed our ever-growing population in the world. That book advocated vegetarianism and I went vegetarian. I had a lot of vegetarian friends in University. I went on to study severe malnutrition and HIV in my PhD work and started working in Subsaharan Africa and got there and was like, Oh, this all seems much more complicated to me than just me going vegetarian. I also didn't have much of a community around vegetarianism, didn't really understand but the advocacy side of it and kind of lost my way with it a little bit.

Then when I decided to open up a private practice after I finished my PhD and returned to living in Toronto, I started to investigate more about what's happening in North America in terms of diet, in terms of the big diseases I need to be aware of when I'm working with people. I was really struck by our situation here in North America, how we're plagued by diabetes, heart disease, diseases that are largely preventable and mostly impacted by diet. Diet being the biggest risk factor for all of them. I quickly realized we need to switch to a plant-based diet. It clicked for me in terms of the environment and in terms of health. It wasn't until after I became vegan that I made the connection with animal ethics as well.

I was listening to a podcast and they were interviewing someone from PETA and I had never really identified as being an animal activist. I came from a family with an agricultural background and that would have felt something quite foreign to me. But I thought this is something I've got to check out. I went back home and watched probably 20 videos on the PETA website and was like, okay, now I'm also an animal activist and advocate. At that point I think it's cemented for me that I would never change my mind about being vegan. I think you can be 90% of the way there with your diet, plant-based for, for health or for the environment, but when it comes to the animals, for me it's 100% commitment and  doing the best you can. I understand, sometimes mistakes happen here or there, but always endeavoring to be vegan. So I don't remember exactly how long ago all that was. A lot of people know the exact date and I'm going to say it was probably like six years ago, something like that. But definitely vegan for life.

Karina:  That's awesome. It's interesting because it sounds like it started with an environmental, sustainability and health focus, which I feel like that's happening a lot nowadays too. People come to veganism first for those reasons and then later it becomes this whole sphere of compassion. Like, Oh wait, it's an ethical thing as well.

Dr. Pamela: I meet vegans all the time and a lot of people walk through different doors into veganism and it doesn't really matter which side people come from. But you know, I really find that most people do get switched on to all three being an important issue for them, once they are vegan.

Karina:  Absolutely. I agree. So let's get into our main discussion topics. We're going to talk about all things vegan nutrition for women, which I'm very excited about. So why don't we start with the stages of life. So we've got a lot of different topics within that realm. So I'll basically just leave the door open for you to, for you to take over.

Dr. Pamela: I get asked questions about young athletes. I think there are a lot of young people who are becoming vegan now. Increasingly we're seeing people raising their kids vegan right from birth. So even in childhood, a lot of people are raising their children vegan now, which is wonderful. As children move into their teen years girls are going to start menstruating and we need to be thinking for young women a little bit about iron. This goes throughout our reproductive years. I do meet a lot of vegans who say, you know, I actually used to be anemic before going vegan. Now that I'm vegan,  I'm not anemic anymore and I have great iron levels and that's wonderful. You know, vegan food is actually very rich in iron particularly beans and greens.

That's a great combination to get your iron requirements. However, you do also meet vegans who are deficient in iron, who suffer from iron deficiency and anemia. Some people who maybe used to be vegetarian if they were eating a lot of dairy cheese, yogurt, milk, calcium can block iron absorption. So that could be a reason for some people why they were anemic when they were vegetarian, but moving into being vegan, we do have a lot of iron in our food but for some people they really are struggling with getting enough iron to meet their iron requirements and this really becomes an issue for women, particularly around the teenage years when we start menstruating. Now is this specific to vegans? I kind of feel like being deficient in iron is very common regardless of diet.

In fact, iron deficiency is the most common deficiency in North America mineral deficiency. So it's definitely not specific to vegans. However, on a vegan diet we are only getting non-heme iron, which can be more difficult to absorb. One trick is to consume iron, and we already talked about beans and greens being great sources of iron,  so for example, a lentil stew with kale, a great way to maximize your iron absorption is by adding in some vitamin C. So squeezing some lime on top of that stew. Or maybe if you're having tacos you can squeeze some lime on the top or add in some red pepper for example. Then you'll be getting a source of vitamin C, which will help you to absorb the iron right. Cooking with cast iron pots is another way to increase your iron intake because believe it or not, you do leech iron out of the cast iron when you cook and that will increase your iron absorption as well.

You can also consider a supplement if you've been low in iron consistently for a while. I always recommend to my clients that they should have their blood work done once a year. If you're noticing that you are low in iron, then you might want to consider using a supplement.

Karina: So does this iron need change at different points in the life cycle? We've talked about younger people. What about pregnancy or what about menopause?

Dr. Pamela: So during pregnancy we have an even further increased need for iron because your blood gets diluted as you can imagine. In pregnancy you just get larger and the volume of blood that you have in your body increases. So your blood, your hemoglobin actually gets diluted. There's more plasma diluting your blood and so you need even more iron.

Now most prenatal vitamins will include iron. You should double-check yours and it's worth just making sure that your prenatal vitamin is vegan. Most will also include iron, but that may not be enough. If you are anemic going into your pregnancy, you may need to also take an additional iron supplement. You can speak to your doctor or dietician about a recommendation of which one to take for your needs. You may benefit during pregnancy with an additional iron supplement. Then as you move toward menopause, often women will find that their iron levels actually improve when their periods stop, because you're not having that blood loss every month. Therefore, your iron levels may actually increase as you age.

Karina: That's a pretty good point. So what are, what are the numbers that we're looking at? So if we were to have ranges of what we're aiming for, I'm assuming that changes? I feel like maybe it's kind of like protein where there isn't really a one size fits all number. You know, like there's no one RDA for protein because it depends on so many things.

Dr. Pamela: There actually is for iron, I've just looked it up. So if you are talking about adult women, then you're talking about between 17 to 19 milligrams per day in women. But the thing is that as vegans, we should be airing towards the upper end of that and we won't really have a problem doing that as long as we're choosing mostly whole food sources. But we should be going towards the upper end because as I mentioned, heme iron is usually better absorbed and that is only found in animal sources.

So we're getting non-heme sources of iron that's still an excellent source of iron and in fact it's less inflammatory. Some heme iron can be inflammatory and can be disease-promoting, so non-heme iron is actually much easier on our body, however, we don't absorb it quite as well. So you probably want to aim at the upper end of the intake requirement in order to make sure that your needs are met as a vegan.

Karina: Right. That makes sense. So that kind of having an idea of how much we actually need combined with your regular blood work, is that kind of a good how do I know if I'm getting enough iron kind of situation?

Dr. Pamela: I would say as well that intake does not equal absorption and just because you are eating a lot of food that contains certain nutrients, that doesn't necessarily mean for sure that you won't be deficient and the opposite is also true. Even low intake can sometimes be enough to prevent deficiency. Your body will absorb what your body feels that it needs to some extent. Also other minerals in your body may be interfering with absorption of certain nutrients. So we can't necessarily just enter everything into chronometer and say, Oh, okay, I'm getting 100% at least of each of my nutrients, therefore I know for sure I'm okay. That's a good indicator and I think it's a great idea to do that once in awhile to enter your diet into chronometer and just check to make sure you are meeting your RDAs for all of the nutrients and micronutrients. But it's not a guarantee and that's why it's a great idea to get your blood work done as well. Feeling tired or cold. Those are signs of iron deficiency.

A lot of women get in touch with me and say that they're experiencing hair loss. There can be lots of different reasons why they're experiencing hair loss, but iron deficiency can be one reason.

Karina: That's a good point. So you just mentioned that there are certain things that might actually inhibit absorption. Was calcium one of those things?

Dr. Pamela: Yes. Calcium and also some compounds in coffee and tea. So if you're taking an iron supplement or if you're eating an iron rich meal thinking, Oh, okay, I'm really going to get my iron here, don't drink a cup of coffee with that meal and don't take your iron supplement in the morning with your morning coffee and don't take it with a glass of soy milk either. So maybe take your iron supplement separately from from a meal where you're getting a lot of calcium or where you are drinking coffee. Don't take it on an empty stomach either because it can for some people cause digestive disturbance. You know, B12 is a very easy nutrient to take and it's one we should all be taking as vegans. Generally it doesn't cause any side effects and there's no risk of over-consuming or any of those things. Just go ahead and dive in there with your B12 and it's easily absorbed. But iron is it a little bit trickier in that we don't want to take too much of it. Sometimes it can cause an upset stomach for some people.

Karina: Yeah, I've seen some iron supplements, like the one that I have is supposedly easy to digest. I don't know if that's actually legit or not.

Dr. Pamela: There are quite a few that are marketed as being gentle and that is true. Those are easier to digest. However, I have had a lot of clients that still experience upset even with the gentle iron formulas. You can try a liquid if you're having trouble with the tablets. Sometimes people will find that the liquids are a little easier on the stomach.

Karina: That makes sense. Maybe we can talk about calcium or just kind of focus on calcium for a second since we've kind of mentioned it in passing. Obviously it's important for us to get enough and that's not something you can test with your blood work. So how do we make sure that we get enough and how are vegans building strong bones basically?

Dr. Pamela: The thing is with calcium, again, it's very easy to get on a vegan diet. Iron and calcium are actually easily found. However we need to be sure that we're consuming a variety of whole plant foods, and that's really the trick with most nutrients is don't restrict your diet too much within veganism. Enjoy foods from all of the different groups within vegan eating. So fruits, vegetables, whole grains, beans and lentils and also nuts and seeds. If you're choosing a variety of foods from across all of those groups, you really will meet most of your nutrient needs.

 

It's also wise to look at some fortified products. You don't have to include those, but they do make it a bit easier, particularly with calcium. Most of the plant-based milks that you find in the refrigerator section at a grocery store will include calcium fortification, and that's at a level that is the same as the calcium found in dairy cows milk. So, if you buy soy milk or almond milk from the refrigerator section, they will contain about 30% of your calcium requirement within one glass, one 250 mil cup. Just make sure that you shake the carton before you pour yourself a glass of nondairy milk because the calcium fortification can actually settle a bit and can kind of settle at the bottom of the container. So if you shake the cup or shake the container before you pour yourself a glass, then you will make sure that you're getting that calcium in every cup.

Karina: That makes sense. That's a good point. I forget to do that sometimes myself. So good reminder.

Dr. Pamela: Sometimes I'll do an Instagram story of myself shaking the thing!

Karina: That's awesome. So tracking our food in something like Chronometer or My Fitness Pal, Is that how to be able to tell what amount of calcium we're getting since we can't do a blood test for it?

Dr. Pamela: Right. One thing you can do, and I would say this is worthwhile if you have osteoporosis in your family, is you can get your bone density screened. If you have low bone density, then you'll want to pay particular attention to your calcium intake and your vitamin D. Let's not forget calcium, magnesium, vitamin D calcium is not the only mineral that's in or vitamin that's important to bone development.

But I do recommend tracking Chronometer once in a while. Some people love to track and they want to track every single day. If you have a healthy relationship with that and that's something that you enjoy, then that's great. But I would get a little concerned about someone who feels that they have to do that, shaming themselves about choosing certain foods or being very conscious of the calorie count every time and weighing themselves very regularly, especially if you have any history of disordered eating. Be cautious around your use of food tracking and be very compassionate with yourself. But tracking once in a while so that you can see if you are missing any key nutrients,  if you have a low intake of calcium or zinc on a certain day, that's fine.

Look at how you're doing over two or three days. If you notice, okay, overall I'm low in calcium all three days, then that's a time to think, okay, it's time for me to step this up. I'm going to add an extra glass of calcium fortified soy milk every day, or I'm going to increase my intake of calcium set tofu or I'm going to include more greens in my diet, beans, greens, nuts, seeds. These are all great sources of calcium, and if you're choosing a variety of them along with drinking some fortified beverage, you'll have no problem meeting your calcium requirements.

Karina; Excellent. Now, are calcium requirements different for females compared to males? Are there certain things that women need to be particularly aware of?

Dr. Pamela: Yes. So we do need a little bit more calcium and also we need our calcium increased during pregnancy to support the development of the baby because we're growing, tissue and bones and teeth - a little human. So yes, we do need to be a little more aware of our calcium requirements. The other side to building strong bones is activity. So weight-bearing exercise is very important to building strong bones and also maintaining our bone density. So being out there and being active is great. Swimming is a wonderful exercise, but unfortunately it doesn't really contribute to our bone density. So if you're, if you're really into swimming, maybe add in a few weight-bearing exercise sessions each week, either by walking or running or lifting weights. Most exercise is weight-bearing, so that's another good way to support healthy bone density.

Karina: That's a good point. My main activity is strength training, but what I do for conditioning is swimming, but I think if that's all I did, I'd probably have to look at my training week a little bit.

Let's move on to everybody's favorite vegan topic, which is protein of course. So I'm interested in your thoughts particularly on women protein needs if that's an issue and protein needs in general based on activity levels. So I'm assuming we're going to need different amounts based on what we're doing with our days and our training, but I'll just leave the door open again just to have a discussion and see where we go with it.

Dr. Pamela: So generally speaking, the advice that I give to vegans is that we don't really need to worry about protein. As long as you're consuming enough calories, then you're getting enough protein and you won't be deficient in protein. There is a little bit of a caveat though for people who have increased protein needs, and you've mentioned already female athletes and this is true for male athletes, but we're focusing on the women today.

So women don't actually have increased needs for protein compared to men. However, doing things like being very active or during pregnancy, we do have increased needs. So if you are an endurance athlete, if you are a long-distance runner, let's say a marathon runner, you will have slightly increased protein needs. If you are a strength training athlete and very into lifting heavy weights, then you'll have even further increased needs.  So the general population you could say is doing great with 0.8 grams of protein per kilogram of body weight per day, whereas someone who is very active should probably have about one gram of protein per kilogram of body weight. A marathon runner, a long-distance runner, someone who's doing very high volume training could maybe go up to say 1.3 grams. Then as you're going up into getting more resistance training, if you're getting very active with weightlifting and bodybuilding, then you could even go up as high as two grams of protein per kilogram of body weight per day.

Karina: Right? I've seen, I've seen different numbers based on the number of days per week that you're training or lifting and that kind of stuff. I don't know if you follow Dr. Anastasia Zinchenko, she's another PhD but very into the strength world as opposed to endurance training. She's done some research on protein needs and stuff and she's recommending between 1.8 and 2.1 grams of protein per kilo of body weight per day, specifically for vegan strength athletes. So these are people who are lifting four plus days a week. So I think what you're saying is we're on the same page, right? If you're vegan and you don't train seriously, you're fine.

Dr. Pamela: If you're doing Zumba three days a week, that is fantastic. If you're out there walking your dog every day, that is amazing. Good for you for being active and moving your body in the way you want to. That's wonderful. 0.8 grams of protein per kilogram per day is wonderful. Don't think that because you'd go to yoga, that means you need to increase your protein requirements. You don't. I talked about endurance training being in the 1.1 to 1.3 grams per kilogram per day, and then moving up towards 2  if you're into the very heavy lifting, so I'm actually completely in agreement with her about her numbers. It's going to vary a little bit depending on just how intense your workouts are on those four days per week, how heavy your lifting, how experienced you are that kind of thing, but generally speaking, that sounds exactly like what I'm saying.

Karina:  Absolutely. I feel like the whole like where do you get your protein from myth is still out there. It's kind of dying off, thankfully, but nobody cares about your nutrition until they hear that you're vegan, especially if you're active and they're like, Ooh, so where are you getting your protein from? It's like this big deal, but I know it's really not.

Dr. Pamela: The funny thing is people talk about protein all the time, and unless you're a very heavy lifting athlete, it's very unlikely that you're not meeting your protein needs, you know. Really what people should be asking more is where are you getting your zinc and what about your iodine? It's fine, but it’s my micronutrients that are an issue rather than macronutrients. That's not to vilify the vegan diet. There's no diet that is absolutely perfect and every diet will have some issues in terms of gaps in micronutrients or of risk areas. So let's not say in any way that this means that the vegan diet is a poor diet or that it has gaps. Every dietary pattern has strengths and weaknesses. Overall, a plant-based diet is the best one in terms of reducing your risk of all of our key chronic disease killers in Canada, which is tying back into why I wanted to become vegan and why I encourage my clients to become plant-based or at least more plant-based in our sessions. But the thing is that it's actually more likely to be micronutrients that are the issue rather than macronutrients.

Karina:  Absolutely. That's a great way of putting it. And I think it goes along with the official position paper, the Nutrition and Dietetics where they have a position paper on veganism, which apparently I heard from Vesanto Melina who's the lead author for that. Apparently it was really difficult getting in the one sentence about how a vegan diet can actually help environmental issues and how it's more sustainable. There's a very short little sentence in that statement, but apparently it was very difficult to get that in there.

Dr. Pamela: It's unfortunate. I'm on the sustainability practice group for Dieticians of Canada and it's unfortunate that dieticians are just kind of moving into thinking about sustainable diet and sustainable food systems issues. It's becoming something that is being talked a lot and we're moving towards a position paper for Dieticians of Canada about sustainable diets. But there was kind of this idea that we should be focusing on health. We're dieticians, we're in health care, but actually there's no doubt that we should, in my opinion, we should also be making decisions about our diet based on the environment and also ethics too. I think all of these things are important. I don't like to silo the decisions that I make about my own diet. When I look at dietary decisions for my clients as well, and we talk about those things, I think we should think about there's no way to eat in this world without having an impact on our world. Environmental, ethical, and also health. So I think we should think in all of those ways. I'm not surprised that she found it difficult to get that into the position paper and I'm so glad she did. Vesanto is an amazing woman.

Karina:  She's like a powerhouse superhero of the vegan world. So can you tell me about your vegan and gluten-free meal plan that you have available? I'm wanting to get our listeners onto your website and to get your resources. So maybe you could tell us a little bit about what you have available.

Dr Pamela: Absolutely. I have for free download on my website, a five day fresh start and it's really  intended for people who feel that they've kind of got maybe a little bit off track with their diet, starting to consume more of the treats, like too many Oreos or vegan brownies or that kind of thing and they really want a fresh start. They want to move back towards choosing more whole foods. The nice thing about the five day Freshstart is that the shopping lists are there. The recipes are all there, so it takes the thinking out of things for you and if you try the fresh start and you'd like it, I have a 30 day plan that goes along with that. I also have if you decide to do a one on one counseling online session with me, you can get that 30 day meal plan included as part of the intro session.

Karina: Perfect. That's really awesome that it has basically everything you need. So it's not just like, Hey, here's what you're gonna eat for five days. It's also here's what you need to get ingredients so that's perfect.

Dr. Pamela: Exactly. That's right. It's helpful for someone who's just starting out on the road to being vegan because when you see those ingredients, those are a lot of the things that vegans have in their pantry. That's something that happens when you first go vegan - you may not have nutritional yeast, for example, you've made have heard of it before. It might be something that you use frequently after you're vegan for awhile. You would never be without it, but it might not be something you encountered before. So it's a shopping list that might help you setting up your vegan pantry so that you're ready to go. Also the 30 day plan talks you through and takes you through a few techniques that will help you with your vegan cooking. For example, using cashews to make a white sauce. I had never done that before. I used to use dairy to make a white sauce and once you know how to use cashews to make a white sauce or a cheese sauce, then it really opens up a whole new realm of cooking that you might not originally have associated with veganism.

Karina:  That's a great point. Honestly, I didn't know what half the foods were that I eat now, even when I was vegetarian. I've been vegan for a while now. I can officially say I've been vegan for half of my life, which I'm very excited about, but even being vegetarian, I didn't know what Tempeh was or nutritional yeast back then. It's a great idea. If nothing else, or even if you're already vegan, maybe it can just be a, Hey, I haven't tried that, or that's something new. That's great. Well, as usual, we're going to have show notes with links, so we've got your website ways to connect with you, ways to do sessions and download what you have available. So we will have that in our show notes and I really appreciate you coming on the show and I've really enjoyed speaking with you and thank you so much.

Dr. Pamela: It was wonderful.

Karina: Thanks again, Pamela for taking the time to speak with me and for sharing your knowledge with our listeners. For our show notes, go to Nobullshitvegan.com/040 and remember that I've got a bunch of awesome free resources for you at Karinainkster.com in case you haven't yet downloaded them.

Thanks for listening to the No-Bullshit Vegan podcast at Nobullshitvegan.com.

The No-Bullsh!t Vegan podcast: myth-busting and evidence-based advice to help you kick butt on a vegan diet!

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